COVID-19 Update: “No economy should override a human life”

From the Midstory Studio, our team chats with health care professional Lauren Uhrman to get an update on the most recent national and local information and discussions on COVID-19, including infection rates and new symptoms, current local and national policy and preventative measures, what the current PPE situation is like in hospitals, whether someone can actually be "re-infected," how the American public is doing with "social distancing" and what we all can be doing better to help fight the spread. Special thanks to Lauren Uhrman for being featured in this update.

Topics covered:[00:25] Current statistics[01:44] How the virus spreads[03:13] Known and new symptoms [04:02] “Re-infections” [04:52] Test shortages and other countries’ successes [06:00, 11:42] PPE explanation and shortages [09:15] Susceptible populations & young people [10:51] The local situation in Ohio & Governor DeWine[12:57] The American public & governments’s inadequate response to the virus[14:34] The tug-of-war between the economy and human lives[16:39] Social (or physical) distancing[19:00] Staying healthy during the outbreak[20:50] The trajectory of the virus in Ohio

Samuel Chang: We featured our conversation with nurse practitioner Lauren Uhrman about a few months ago when the coronavirus issue was just getting going in the United States. We’re happy to have her back in the studio to talk more about some updates on the coronavirus. Thank you, Lauren, today for joining us here at the Midstory Studio.

Lauren Uhrman: Thank you for having me, Sam.

SC: Yeah, so I guess we should jump right in. What has changed since the last few months that we last talked?

LU: Well, last time we talked, we were talking about how we should prepare as a nation and, especially health care providers, prepare for what could possibly come, so that we wouldn’t be scrambling around. Unfortunately, that’s exactly what happened, so now our country is pretty much leading the world with the number of cases of coronavirus as we speak.

SC: So how many cases today are we looking at?

LU: We have, currently in the United States, as of this morning [03/28], I believe over 104,000 cases of coronavirus.

SC: So that’s more than China?

LU: China’s about 81,000. Italy’s about 84,000, so we are, as of right now, leading with the number of cases. As we know, that number is probably much higher because of a lack of testing. Our death rate is about, I believe, 1,100 or so.

SC: Okay, yeah. Well, why the sudden jump in numbers just recently?

LU: Well, as we knew, the virus kind of originated in China, but with all the travel—everyone’s been traveling around—and I don’t think our country was prepared, so nobody was really taking precaution, kind of living life as usual, so this virus spread very rapidly.

SC: So since the last time we spoke, and we talked a little about the preliminary understanding of COVID-19, have we learned anything new about the way this virus is acting and anything that we can share with the audience today?

LU: Yes, so at first—and this is not officially confirmed—but, in the way it spreads, we think it’s through droplets. So respiratory droplets, meaning a sneeze or a cough is containing lots and lots of the virus—the coronavirus—so if someone coughs or sneezes and it gets into someone else’s eyes, nose or mouth, then they’re most likely going to get the coronavirus. Now if they cough or sneeze onto a surface, like, you know, a door handle or a table, it’s shown that it can survive quite a long time. So if you go ahead and touch that surface, then, as we know, we touch our eyes and our nose and our mouth all the time, that’s a perfect—

SC: And how long is it, you know, for the surfaces?

LU: As of right now, they’re saying copper is about four hours, cardboard 24 hours, plastic can be up to 72 hours—which is pretty scary—and we also believe that it can be aerosolized, like float in the air, for about three hours, so once the person leaves, the virus can still hang out in the air. They’re also discovering that it could also be in the stool. So someone has a bowel movement, then the virus can actually be there.

SC: And new symptoms—are we seeing new symptoms pop up from the coronavirus?

LU: Actually, yes, we are. So, as we know, with coronavirus, the most common symptoms are fever, cough, shortness of breath, and that can lead to severe pneumonia and ultimately ARDS, as we talked about, and possibly death. Now, they’re also seeing some mild symptoms of headache, sore throat, diarrhea, abdominal pain and, just recently, it’s been discovered that there’s a lack of smell and lack of taste, so those could be the first warning signs of this illness. And I also read something about a nurse in Washington—Washington state. She discovered that a lot of her patients had red eyes, and then they actually ended up having coronavirus. So there’s a lot of unknown, but this is what we know so far.

SC: And people can get it again? Is that something—

LU: Well, there’s a debate about that. In China, they’re having people that tested positive, recovered, tested negative and now are testing positive again. I don’t know how much that is true. I think I’ve also read that it could be due to the testing, so you could have a very weak positive test—or viral load, I should say—depending on how much virus you have in your body at that time they do the test. So if you have a high viral load, it’s going to be very positive. If that viral load decreases and you test yourself again, it could be weakly positive but show up as a false negative. And then maybe something reactivates it again and you show positive. So I don’t think it’s really reinfecting, I think it’s just—I think it’s still the same virus.

SC: Sure. And you talked just now about tests. There is a massive shortage in tests all across the world right now.

LU: Yes.

SC: Why are we seeing that?

LU: Well, again, it comes back to—our country was not prepared. There was—the first tests they made, they were faulty, they didn’t work well. We just don’t have enough tests or we just weren’t prepared. If you look at other countries, like South Korea, they’re testing almost, I think, everybody, and maybe Taiwan, as well —they’re doing that. So their numbers are quite accurate. And that, actually, I think is better for the country because it makes everybody feel safer, in a way, because then they know for sure, “I have this. I need to stay at home,” for example. But here, basically we’re only testing health care providers and those that are really, really sick requiring hospitalization. So so many people are running out in the community, they have no idea if they have it or not.

SC: Yeah, so definitely a few things to learn from some of the East Asian countries.

LU: Absolutely. Yes.

SC: So I actually recently received a request for PPE collection from the community. It seems like—you know, it’s all over the news now—we have a massive shortage, and I’m sure in your hospital experience, that’s also the case here. Why do we have a shortage and can you speak a little bit more about, you know, what exactly is PPE?

LU: Sure. So PPE stands for personal protective equipment and it basically is, for example, a face mask, face shield, gloves, gown, goggles, and that protects us from certain diseases, for example, these respiratory droplets. So it would protect us health care workers or people in the industry from, you know, hazardous material. So we have a great lack not just in this country, but worldwide, but specifically in this country. Number-one reason, I think, is because we weren’t prepared. This is not a new issue. I think for the past couple decades, we’ve not been prepared for something as big as this. Public health, unfortunately, is not at the forefront of America. So we’re really struggling to have enough PPE to protect our health care providers. Some other reasons are—mass production is China. And when the outbreak happened in China, they used up all the PPE. The production was for them. Unfortunately, people hoard, as well. So in this country, people get scared, so they buy a lot, a lot, a lot, and, you know, then that leaves the health care workers vulnerable and there’s not enough.

SC: Yeah, and about these shortages—I hear a lot of news these days about ventilators and respirators. Can you talk a little about, you know, why it’s so important to have both of those and what are the differences between that equipment?

LU: Sure. So a respirator is actually a type of a PPE. So respirators are what health care providers would wear. So the two most common are N95, which you have to be fit-tested for and it’s a very tight-fitting mask that you wear to prevent airborne or droplet materials from coming into contact with our face, our nose and our mouth. So health care providers wear those when they’re going into a patient’s room that has COVID-19, or more specifically, like tuberculosis or measles or sometimes flu, as well. A ventilator is actually a machine, so mechanical ventilation is a machine that will help a patient who is having respiratory distress or acute respiratory failure. It helps them to basically stay alive and to breathe. So it has a tube that goes in through the mouth, down through the trachea and into the lungs that provides oxygen for the patient to survive and it also releases CO2. So ventilators are critical for people to survive. Unfortunately, with this current disease process, it really puts people into respiratory failure. Not everybody, but a lot of people are suffering from severe pneumonia, which can lead to this Acute Respiratory Distress Syndrome called ARDS, which you ultimately have to be on a ventilator to survive. Unfortunately, this country, I believe, only has 180,000 ventilators, which—it’s not a lot, especially if—think about it. Our cases right now are at over a hundred thousand and we’re not even at the peak.

SC: So I kind of want to circle back around to, you know, one of my earlier questions about what we know to be new about COVID. I keep seeing these posts in Florida about a lot of young people that are going out there. They’re still partying on the beach, they’re enjoying their spring break, and you’re seeing that they’re having to shut down a lot of these beaches. Of course, that’s a lot of concern, because this thing, as you’re saying, it’s easy to spread among these individuals, and I think now we’re starting to see the backlash of those beaches still being open. I think there’s a lot of these posts from, you know, both my friends and some individuals out there, a lot of young people saying, “You know, it’s not gonna affect me.” I think the numbers are changing. Can you speak a little bit to the numbers? How are they changing? How are they affecting young people?

LU: So, what we knew from the beginning was that we thought that this virus only affected elderly people, 65 and above, typically with comorbid conditions. We thought those were the most affected and that young people either had no symptoms or very mild symptoms. That’s actually quite wrong. We’re learning that anybody can be affected, from actually a newborn all the way to a 100-year-old person—they’re all being affected. Yes, maybe young people are having very mild symptoms, but we’re also seeing young people—perfectly healthy 20-year-olds, 30-year-olds with no previous health conditions—acquiring this disease and actually having very severe infection, some actually being put on a ventilator.

SC: So how about the local situation? You know, what are we looking at locally? I mean, in your line of work, you’re essentially at the frontlines, in many ways. So what are we seeing locally? Are there shortages right now in Toledo, or are we still doing alright? You know, what does it look like locally?

LU: Yes, well, let’s compare to the current epicenter in New York City. So they have about 23,000 cases as of today, 365 deaths, and it’s just beginning. Locally, in Ohio, we have about 1,100 cases and only 19 deaths, and then right here in Lucas County we have, as of today, 50 cases and only two deaths. And if you compare ourselves to Michigan and Pennsylvania, we’re actually doing better, probably because of Governor DeWine’s strict policies that he enacted sooner rather than later. But we are definitely at a shortage of PPE. Even me, myself, where I’m working, and I know the local hospitals are also struggling to have enough PPE, and we are just at the beginning of this outbreak.

SC: Are you having to reuse the PPE? Is that something that is going on right now in the hospitals?

LU: Yes. In order to conserve our PPE, we’re having to actually reuse them. CDC gave us some guidelines, so that that could be okay. Basically, you wear a surgical mask, which is one of these [Lauren shows a surgical mask from her pocket]. You rewear the same one over and over again until it becomes saturated or wet, then you need to change it. N95s, we’re basically wearing and then you can wear a surgical mask over it to protect it or, also, in the community there’ve been people actually sewing masks out of fabric and donating them to us and you can wear those just as a protective mask to protect the N95.

SC: And that’s a way for community members to help out in the situation?

LU: Yes. They’re trying to do anything they can to help the situation.

SC: Yeah, and there’s been that recent call for respirators and masks. Is that still something that hospitals are looking for?

LU: Yes. We are all in dire need of them.

SC: From a medical standpoint, and you keep kind of going back to this line that we could have been more prepared, I think, both in our community and politics, I think in hospitals. So from a medical standpoint, how could we have been more prepared?

LU: Well, I think we all could have been more aware of the situation—educate ourselves. Unfortunately, our country is—we’re pretty free, we like to do what we want—that’s Americans—and we don’t like to be limited. I think the general attitude was, “Wow, this is bad in China (or other parts of the world), but it’s probably not gonna hit us.” I don’t think anyone could have imagined that it would have hit us. And I don’t think that’s just the general public, I think that’s also health care workers, too. They didn’t think it would be this bad, and if you hear testimonies of doctors around the country—there’s that doctor in New York and she was like, “If you asked me three weeks ago if I would have thought this would have come to us like this,” she said no. I think it’s just a lack of preparation and just a lack of awareness—not really feeling the urgency that this would come to us.

SC: So, in some ways, there are things that we certainly could have prepared more for. In other ways, there are certain aspects of this virus—just its unpredictability—that, in some ways, it was very difficult to prepare for, as well.

LU: Yes, but like I said before, I think the shortage of PPE and ventilators is not a new thing. It’s been going on for decades because public health has been pretty much pushed to the side. I don’t think that’s at the forefront of our minds because our country hasn’t really suffered an outbreak like this, or a pandemic like this, for quite a while. Other parts of the world, yes, but nothing like back in 1918—the Spanish flu—or the Black Plague, for example.

SC: Actually, we recently released an article talking about the mayor of Toledo back then [1918], talking about how human lives are not something expendable. I think today, in both national conversations, in politics, you’re hearing from our federal government this kind of juxtaposition of human lives versus our economy. What are your thoughts? And this is of course personal thoughts, but what are your thoughts about that?

LU: Well, I think we all know the world is run by money. That’s unavoidable. Unfortunately, our country is too. I think we all understand that though it’s devastating for the world to stop, and our country is not meant to stop—it’s meant to keep going—but I personally feel as a health care provider, as well as a human being, that no economy or no money should override a human life. To me, a human life is priceless. And actually I wanted to quote something for you. I think we all have heard the governor of New York. He said, “No American is going to say, ‘Accelerate the economy at the cost of human life,’ because no American is going to say how much a life is worth. Job one has to be save lives. That has to be the priority.” And this is on a more personal level, he says, “My mother is not expendable and your mother is not expendable. We’re not going to accept a premise that human life is disposable. We’re not going to put a dollar figure on human life. We are going to fight every way we can to save every life that we can, because that’s what I think it means to be an American.” And I 100% agree with him.

SC: So you’re seeing a lot of statewide leaders come out. I think Governor Cuomo is one of those individuals who has kind of stepped into the forefront talking about this issue, and I think that’s mainly because New York City is currently the epicenter of, you know, this virus. I think you’re seeing that across the board, too, in Ohio. I think we’re very proud of a lot of the policies that Governor DeWine has implemented as well as under the direction of Dr. Amy Acton. Can you speak a little about the shelter-in-place order and the social distancing policies that are in place right now? Do you think that they’re effective? What’s the timeline look like for something like this potentially?

LU: Sure. I think it’s definitely effective. It has been shown back in 1918 that it is effective because really the only way to stop this spread—or you hear a lot about “flatten the curve,” which means instead of having this high peak, we want to actually flatten it so that we can kind of slow it down, so that we can kind of give our country time, and the health care field especially, time to kind of recover so that they can catch up. So the way that we do that is actually—we use the word “social distancing.” I think a better word is “physical distancing,” because we need a social life. We do need to talk to each other. That’s why we have the wonderful thing of technology—we can FaceTime each other—but it’s actually practicing physical distancing. So, as we know, this virus is spread basically through physical contact, so how you avoid getting this virus is you’re not near people that are sick or people that are actually carrying the virus and don’t even know it. That’s the scary thing: a lot of us can be carrying it and have no symptoms at all. We sneeze and then you get exposed to it. So with physical distancing, you’re actually staying at home most of the time, you’re only going out as necessary, as needed, but that is actually pretty much slowing the spread. It’s hard, but I think this is really the only way right now that we can catch up as a country. So yes, most of us need to stay at home. Only essential workers need to go out, like myself as a health care worker. We should very much so limit our time at the grocery store, in and out—some of them are actually delivering groceries, which is great. We definitely need exercise, so the great thing about this area is we have the Toledo Metroparks, but you also need to practice social/physical distancing.

SC: Right, at like six feet, like we’re doing.

LU: Like what we’re doing right now—exactly. So even at the parks you need to run outside, you need to get some sunlight and some exercise, but you should distance yourself from others, you know, stay away from others. And it’s also the same thing at home. So if you’re at home and you’re sick, you should definitely isolate yourself away from your family, meaning stay in a certain area in your house, wear a mask, you should definitely limit contact with your children, with your husband, with your wife, with whoever, your grandma, whoever is in your house.

SC: Yeah, and we want to keep our parks open and there’s been cases where there’s a lot of conversation, in New York City, for instance, where these parks are shutting down.

LU: And that’s because people are not following the guidelines. Unfortunately it’s a lot of younger people that think they’re invincible to this virus, so they just continue to live life as they normally would, but that’s really causing a rampant spread. So when that happens, unfortunately, parks will have to close because I don’t think our governors can allow such a thing to happen.

SC: Have you been pleased with our reaction here in Ohio? Are there things that you think we could be doing a little better job on, just personally speaking?

LU: I think we could definitely be doing a better job. I still am finding people that aren’t really aware and don’t think this is a big deal. I still see people out and about, the grocery stores are pretty overloaded. I wish that wasn’t the case, but it currently is. And I think people are still coming together, you know, going to each other’s houses, having parties, when this is not the time for that.

SC: The President recently gave a speech and an update on the coronavirus, and he said that he’d like the country to return to work by Easter. I mean, just from a medical perspective, do you think that’s even feasible? Do you think that’s something we should do, or what are your thoughts on that?

LU: Unfortunately, I think that’s absolutely not true. I don’t see any way of that happening. Actually, Governor DeWine spoke with Cleveland Clinic this morning and they were—through a modeling that they have, they are depicting that this could peak not until mid-May, just in Ohio. So you can imagine those other cities like New York.

SC: I think that was 10,000 cases a day?

LU: 10,000 cases a day if we practice social distancing. If we don’t, if we don’t mitigate, if we don’t do anything, about 50,000 cases a day.

SC: Wow.

LU: So that’s just in Ohio and we actually have—

SC: And the modeling is pretty accurate to this, you know, from what we’re seeing right now?

LU: Yes, and that’s just in Ohio, so you can imagine, like I said, other states.

SC: I’m assuming that other states and their policies will also affect the algorithms and what we’re seeing from this, depending on if states quarantine and close their borders and those kinds of things.

LU: Yes. So, unfortunately, back to your question, I do not see this subsiding around Easter. This will probably take several months, if not years.

SC: We have a virtual crowd today, hopefully anywhere from a hundred to a thousand people that are watching this video. What would you say to them, from the young to the old? Are there any things that you want to deposit to them today?

LU: Yes. I would say that this virus is not a joke. The reality is, it’s here. It’s right at our front door. We’re facing it right now, so this is not something we can take lightly anymore. We have to face it. So I think we should all—we shouldn’t be ignorant anymore and we should definitely educate ourselves about what’s happening around the world and what’s happening right here in our own country. And the biggest thing is we should practice this social distancing, or physical distancing as we should call it, and the stay-at-home order, because that’s the only way we’re gonna really slow this spread down. And also, if anyone is sick, they should stay at home. They should not go to work and infect other people. So this is—it’s not a joke. This is how we’re gonna slow the spread. Another huge thing to do that we’ve heard hundreds and thousands of times: we have to wash our hands, and we have to wash our hands properly. Hand sanitizer is great, but plain old soap and water—any kind of soap, bar soap, is the best way—a good 20 seconds, scrub the germs off your hands. That’s one very good way to stop this spread, to prevent ourselves from getting sick and prevent others from getting sick. And also, we should not touch our eyes, nose or mouth, because that’s how we’re gonna get ourselves sick, as well.

LU:Yes, very simple measures, but I think that’s critical to how we can slow this spread today.

SC: Well thank you so much for coming today to our studio, and we definitely thank you for your service to our community and look forward to our next conversation.

LU: Thank you, Sam.

SC: Well, I hope you all learned something new with me today. We’re definitely grateful to have health care professionals at the frontlines fighting day and night to ensure the safety of the American public. I believe that we all have a role to play and that this will take a collective effort for us to stop the spread of the virus. If you enjoyed today’s conversation and want to see more, give us a like, give us a comment below. Share this with your family and your friends as we try to spread awareness on this specific issue. My team and I are constantly being productive during this time of pause and consideration; we’re at home, thinking about what content to bring to you. And right now we’re in the works of a few podcasts and video series, so definitely keep tabs on Midstory, as we want to bring you the best content in time. I hope you’ll join us—from your home, of course—as we grow our region one story at a time. Remember: be safe, be proactive, be responsible, be human. Together, we can do this. I’ll see you soon.

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